Practical questions on ketamine use

[blig-blug]

I may soon have the chance to explore the ketamine space. I have been reading everything I can about it, particularly related to safety (including the sticky thread here). As the dissociative experience is an experience I've never had, I still have a couple of practical questions about it.

First, about the risk of taking it alone. I understand it's preferable to take it with a trip sitter, but I tend to always trip alone. So I'd like to know if the advice of taking it with a trip sitter is just general advice (as one would generally advice with Ayahuasca, for example), or it's a must for safety. From what I have read, I got the impression of it being a must, but I'm still not sure. I don't want to do anything reckless.

Then, there is the question of dosing. My intention is to use it in a therapeutic and spiritual way, and that will require moderate-high doses. Would you recommend starting very low and gradually increasing the dose in successive experiences? Or is a moderate dose reasonable from the get-go? This is in the context of someone moderately experienced with high doses of psychedelics but zero experience with dissociatives.

Last, there is the question of addiction and physical harm. My plan is to limit use to once a week as an absolute maximum. Is this reasonable from a physical safety standpoint, or would you say this already presents moderate risks of physical harm? About psychological addiction and compulsion, have you had the feeling of "needing" to take more after an experience, when the experiences were moderate-high doses spaced out by several days?

I'll appreciate any information or guidance here!

 

[Voidmatrix]

Titrare in and you should be fine.

Are you using nasal spray or lozenges?

Moderate dose should be a good start. You can always redose.

Once a week may be a bit much, but I'm paranoid and won't use it more than bi-weekly but am usually around once a month.

One love

 

[Nydex]

I'm so excited for you to wade deep into the Ketamine waters!!!

My experience with it isn't vast, but I will share my two cents for what they might be worth.

There is a certain risk of taking it alone if it's the first time. Some people tend to vomit on Ketamine, while others don't. I'm thankfully from the latter group, but I know some people that basically purge every single time they take it. If you happen to take a larger dose, and have the misfortune of being in that group of people, the risk of emetoasphyxia is real and can endanger your life. So for the first time, I would recommend having a sitter, and starting off with a moderate insufflated dose shouldn't be an issue.

If you can't get a sitter, I would strongly recommend starting off with a very low dose and working your way up over a few weeks. Keep in mind your experience with psychedelics won't necessarily translate to experiencing a strong dissociative like Ketamine.

Addiction can be a risk for people that have addictive tendencies or are actively suffering from a mental (or other) health issue that is strongly alleviated by the Ketamine experience. Physical harm has already been discussed in the face of kidney damage, and I'd say doing it once a week is a bit too often. I'd recommend no more than once a month, going for a deep experience, but I suppose you can get off with once every three weeks if you monitor your kidney health carefully.

Hope that helps!

 

[Voidmatrix]

Also, don't have any harmalas in your system.

One love

 

[Varallo]

Nice, ketamine can be wonderful

Good choice to explore this. It’s definitely an interesting step to take.

About taking it alone: I always do. Starting by yourself is fine, just begin with a low dose. Having someone with you is only really needed if you plan to go high right away.

Ketamine is one of those things where you can just take a bit more until it feels enough. You don’t need a full dissociative trip for it to work. The experience is short anyway, so if it gets too much, give it 20 minutes and it will ease off quickly.

I’d suggest making a nasal spray and dosing gradually.

In terms of frequency, once a week sounds reasonable albeit a bit high. On the risks some people get bladder issues faster than others, so it’s hard to predict, but spacing it out minimizes risk. Personally, after a few days in a row, I already feel it, which helps me not overdo it.

I’ve never really felt the urge to take it more often than every few months, though that varies from person to person.

Overall, it’s an interesting experience, but it’s not on the same level as things like Ayahuasca or DMT.

It combines very nicely with vaped DMT

 

[blig-blug]

Thank you for your replies!

Are you using nasal spray or lozenges?

So far nothing yet, in the future it can be either. I can't be more specific, but let's just say that I first have to test it. I'm inclined to use it sublingually, but I can't find much information about dosing beyond doses for depression. So I'm open to oral use or making a nasal spray if that's a better way.

Once a week may be a bit much, but I'm paranoid and won't use it more than bi-weekly but am usually around once a month.

I'm going to stick to that as well, then. I also prefer to be paranoid about it. If it feels as difficult and challenging as Ayahuasca does in a way that I have to force myself every time I won't be that worried. But from what I've read it's likely to be much more pleasurable. I may publicly log the experiences here to keep myself accountable.

There is a certain risk of taking it alone if it's the first time. Some people tend to vomit on Ketamine, while others don't. I'm thankfully from the latter group, but I know some people that basically purge every single time they take it. If you happen to take a larger dose, and have the misfortune of being in that group of people, the risk of emetoasphyxia is real and can endanger your life.

This is one of my worries. I used to not vomit almost for any reason (although who knows it that would translate to ketamine), but lately I've been having more GI issues. I'm going to keep this in mind for sure.

If you can't get a sitter, I would strongly recommend starting off with a very low dose and working your way up over a few weeks

I think I may be able to get a sitter for the first couple of times, it depends. If not, I'll follow your suggestion of going up over some weeks. After a few months my girlfriend will be back and will be able to be my sitter, so I may wait until that point to take a significant dose. I will do that for sure if I see it causes me GI symptoms.

Addiction can be a risk for people that have addictive tendencies or are actively suffering from a mental (or other) health issue that is strongly alleviated by the Ketamine experience.

Yeah, is the potential relief what I fear. Nowadays I'm generally happy and stable, but I'm still overly alert, as if in danger. The fact that it could help is both positive and negative. This inclines me even more to log about it here, as it'll help me examine my thoughts and feelings about it in a more objective way. And maybe some other people could help me spot any worrying pattern if they were to appear.

Physical harm has already been discussed in the face of kidney damage, and I'd say doing it once a week is a bit too often. I'd recommend no more than once a month, going for a deep experience, but I suppose you can get off with once every three weeks if you monitor your kidney health carefully.

In terms of frequency, once a week sounds reasonable albeit a bit high. On the risks some people get bladder issues faster than others, so it’s hard to predict, but spacing it out minimizes risk. Personally, after a few days in a row, I already feel it, which helps me not overdo it.

I'm going to set a monthly limit, then. Maybe for the titiration phase I'll set a bi-weekly limit, and once I find the right spot I'll make it monthly. I'm aware of the risk of ending up deciding to keep it bi-weekly, so that's in part why I'm writing it here. I'm a bit paranoid about addiction, like @Voidmatrix said.

Keep in mind your experience with psychedelics won't necessarily translate to experiencing a strong dissociative like Ketamine.

Definitely. I want to be cautious about it. I'm sure it's like psychedelics in the sense that reading about it or experience with other substances can't really prepare you for it. Only give you a slight idea.

About taking it alone: I always do. Starting by yourself is fine, just begin with a low dose. Having someone with you is only really needed if you plan to go high right away.

Good to know that it's not an insane idea. Once I'm sure it doesn't cause me to vomit, I'll consider it. As generally it's much better for me if I trip alone.

I’d suggest making a nasal spray and dosing gradually.

Do you have any advice on concentration? I've read that they usually range between 100mg/mL and 200mg/mL.

I’ve never really felt the urge to take it more often than every few months, though that varies from person to person.

Good to know, still. I'm sure it depends also on the patterns of use. For example, I've used amphetamine in times of exams, and never had any issues to stop taking them once exams were over, or any desire to keep going. But I kept it at a maximum of 10mg per day, oral. If I had been insufflating unmeasured lines it may have been different. So I hope establishing a well-delimited pattern of use for ketamine will help me not have any issues.

Ketamine is one of those things where you can just take a bit more until it feels enough.

It combines very nicely with vaped DMT

Noted! I'm sure I'll explore this at some point. Once I have some experience with ketamine on its own.

Also, don't have any harmalas in your system.

For sure, I'll be very careful about that.

Thanks again for your answers! They are very helpful to me.

 

[Here&Now]

Ketamine is pretty nice. It's one of the few substances I like besides psychedelics. So relaxing, and it automatically dissolves fear as part of how it works. It's more bland than classical psychedelics, but it makes up for that with other attributes. And like Varallo mentioned, it makes for quite the combo with DMT. Just watch out for dosing too high due to the potentiation.

Did you have an ROA picked out? IM and SC injection works for ketamine, and a lot of people prefer that if you already have experience with that kind of thing. For me, 50mg injected is where the experience starts becoming mind-expanding rather than merely relaxing. That equates to 100mg nasally. Probably best to start with 25mg injected/50mg nasal to see how you react.

Taking a single dose once per week seems like a reasonable way to go about it. I followed a similar cadence at one time. Though based on reports I was reading on Reddit, you can eventually experience bladder issues at that frequency. That may or may not be specific to the individual.

 

[blig-blug]

Did you have an ROA picked out? IM and SC injection works for ketamine, and a lot of people prefer that if you already have experience with that kind of thing.

I do have experience with SC from dabbling with peptides in the past. Unfortunately, I don't trust enough the material I'll have so as to inject it in any way. I'll consider SC in the future if I eventually have the possibility.

Probably best to start with 25mg injected/50mg nasal to see how you react.

From what I've been reading, 50mg nasal sounds reasonable to start. The lowest dose of Spravato is 56mg, and they give that to people without experience with mind-altering substances.

Taking a single dose once per week seems like a reasonable way to go about it. I followed a similar cadence at one time. Though based on reports I was reading on Reddit, you can eventually experience bladder issues at that frequency. That may or may not be specific to the individual.

The idea was more of an absolute maximum than a desired frequency. I don't want it to interfere too much with my Ayahuasca sessions, and given the dangers of interaction with harmalas I want to keep them well apart. But I still want to have an absolute limit in case I somehow change plans.

 

[Here&Now]

The idea was more of an absolute maximum than a desired frequency. I don't want it to interfere too much with my Ayahuasca sessions, and given the dangers of interaction with harmalas I want to keep them well apart. But I still want to have an absolute limit in case I somehow change plans.

Right, and the duration of effects is something to keep in mind as well. Ketamine has a way of lingering in your system, much more so than most psychedelics. It's part of the reason people use it for depression, but it can also be looked at as a negative. You'll likely feel sluggish the next day, and it'll be as if a little piece of the ketamine experience has remained active in your brain for multiple days afterward. You'll have to decide whether that's a good thing or not. I wasn't the biggest fan of that aspect.

 

[Varallo]

Do you have any advice on concentration? I've read that they usually range between 100mg/mL and 200mg/mL.

I like to be in the higher range because you need less spaying and therefore reduce the dripping.

 

[redbird]

I’d suggest making a nasal spray and dosing gradually.

Do you have any advice on concentration? I've read that they usually range between 100mg/mL and 200mg/mL.

I'm curious about this as well. My wife would enjoy the effects but has terrible burning from insufflation and finds the drip awful. It completely takes her out of the experience. In trying to solve for that we were going to try a rectal solution but she would probably prefer the nasal spray for obvious reasons lol
I would assume the drip is comparable but does it have the same burning effect as insufflated powder does?

As far as dosing, is there a reason you can't have a sitter for your first session? It seems to me you're better off trying a small amount (.25mg/lb bw insufflated) to confirm no obvious reaction to it, then decide on your ideal dosage (personally i prefer .75 to 1mg/lb bw for doing interal work) and decide whether you want to do that first go with a sitter or start at 1/2 to 2/3 of ideal dose with a sitter. After that you should have a handle on how your body reacts and go from there.
I'm not saying you can't experiment without a sitter but from a harm reduction standpoint I would strongly recommend having one for the first session or two. You're likely to be more grounded in your body than most given your experience with other medicines but as other posters have said, the dissociative space is very different and that experience doesn't translate 1 to 1.

 

[Here&Now]

In trying to solve for that we were going to try a rectal solution but she would probably prefer the nasal spray for obvious reasons lol

Besides having a lower bioavailability and needing more substance, I have heard good things about rectal for ketamine as an alternative to nasal.

 

[Varallo]

I also find powdered ketamine irritating, a nasal spray reduces this for the most part, though the drip remains. Proper insufflation technique helps, but a bit of drip is unavoidable.

 

[yatyas314]

I used lozenges and I took a moderate dose alone, I probably won't do it again. I was really relaxed, but did not like how impaired I was when I had to go pee. I think Void nailed it titrate up and see where your sweet spot is.
Safe Travels
Y

 

[blig-blug]

As far as dosing, is there a reason you can't have a sitter for your first session?

I very likely will be able to. If I can't is just because my girlfriend will leave for some months and where I am right now there are only about 10 people more, old farmers. So no one to be a trip sitter.

I'm not saying you can't experiment without a sitter but from a harm reduction standpoint I would strongly recommend having one for the first session or two.

Based on what has been said in this thread yes, I'll do my first couple of experiences with a trip sitter. If that's not a possibility anymore until a few months later, I may consider working up from very small doses and see how I react. Likely I will wait to have my first moderate-high doses with a trip sitter.

You're likely to be more grounded in your body than most given your experience with other medicines but as other posters have said, the dissociative space is very different and that experience doesn't translate 1 to 1.

Yes, I don't factor much my experience with other substances. Also I have still some unresolved issues from my past that may come up in a different way than they do with psychedelics. I'm going to be cautious.

'll likely feel sluggish the next day, and it'll be as if a little piece of the ketamine experience has remained active in your brain for multiple days afterward. You'll have to decide whether that's a good thing or not.

In my case, chances are it helps me with my hyper-vigilant state. We'll see. If it makes me too sluggish so I can't program comfortably I'll probably not like it.

I'll consider the rectal ROA too. I haven't ever tried it but the idea doesn't bother me too much. Maybe because I had suppositories as a kid lol.

 

[Here&Now]

In my case, chances are it helps me with my hyper-vigilant state. We'll see. If it makes me too sluggish so I can't program comfortably I'll probably not like it.

I'll consider the rectal ROA too. I haven't ever tried it but the idea doesn't bother me too much. Maybe because I had suppositories as a kid lol.

lol, for sure. There's a stigma around it, probably due to the partly sexual implications, but rectal really is a good ROA. From what I hear, it's also a usable method for DMT and 5-MeO-DMT.

 

[Voidmatrix]

It combines very nicely with vaped DMT

Just what I needed to see!

Every time I do ketamine, it "talks" to me about DMT.

One love

Ps Sorry not sorry for the derail

 

[blig-blug]

Thanks everyone that replied to this thread for your advice. I have now experimented several times with ketamine. Except for the first couple of times (at very low doses), I've been using the rectal ROA.

It seems that I absorb it very slowly and poorly through that route: up to 275mg ketamine rectal didn't put me in a fully dissociative state, and it plateaus for almost 2 hours. This last time, after being disappointed by the intensity of 275mg rectal, I had another 60mg intranasal after I had mostly come down, and the difference was very significant. Of course, those 60mg were on top of already high blood levels of ketamine, but the difference was qualitative. I think the onset being much more abrupt may lead to a fuller dissociation, even if I didn't get there yet. So I think from now on I'll experiment intranasally, I fear I've wasted a lot with the rectal route.

I would ideally like to try subcutaneous, but I don't think the ketamine I have would be fit for that, as it's not sterile. Suppose it were dissolved in sterile water, boiled for several minutes, and injected subq through a needle with a micron filter. Would that be reasonably safe, or is it still reckless? I don't want to risk an infection or worse.

 

[Here&Now]

Thanks everyone that replied to this thread for your advice. I have now experimented several times with ketamine. Except for the first couple of times (at very low doses), I've been using the rectal ROA.

It seems that I absorb it very slowly and poorly through that route: up to 275mg ketamine rectal didn't put me in a fully dissociative state, and it plateaus for almost 2 hours. This last time, after being disappointed by the intensity of 275mg rectal, I had another 60mg intranasal after I had mostly come down, and the difference was very significant. Of course, those 60mg were on top of already high blood levels of ketamine, but the difference was qualitative. I think the onset being much more abrupt may lead to a fuller dissociation, even if I didn't get there yet. So I think from now on I'll experiment intranasally, I fear I've wasted a lot with the rectal route.

I would ideally like to try subcutaneous, but I don't think the ketamine I have would be fit for that, as it's not sterile. Suppose it were dissolved in sterile water, boiled for several minutes, and injected subq through a needle with a micron filter. Would that be reasonably safe, or is it still reckless? I don't want to risk an infection or worse.

Yeah, rectal seems to have terrible absorption in your case. I believe that's just how it is for some people with that ROA.

For the subcutaneous route, is it the purity of your ketamine that you're concerned about or the sterility? Creating a reasonably sterile solution shouldn't be the most difficult thing, but you may not want to inject ketamine that was made in some random kitchen lab. For sterility, mindfulness of clean handling and passing the solution through a micron filter into a pre-sterilized vial will go a long way.

Also, the SC ROA is incredible for ketamine. I can't imagine a more comfortable and efficient way to use it.

 

[blig-blug]

For the subcutaneous route, is it the purity of your ketamine that you're concerned about or the sterility? Creating a reasonably sterile solution shouldn't be the most difficult thing, but you may not want to inject ketamine that was made in some random kitchen lab

I'm mostly concerned about the sterility. I've tested it with both reagent testing and TLC, and I can't find any impurity, so if there are any the amounts must be very low. I think ketamine is not usually synthesized by small scale operations because it's not easy (unlike PCP), but I don't know. I would never IM or much less IV it, but purity wise it seems good enough for subq.

Thank you for your advice on sterility. I'll maybe try subq in a few weeks, when I have better access to supplies for it. I have experience with subq from peptides, I never had an issue with those but they were already sterile.